Provider Demographics
NPI:1053561480
Name:SELECT RX LLC
Entity type:Organization
Organization Name:SELECT RX LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BORELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-822-0900
Mailing Address - Street 1:165 VETERANS CIR
Mailing Address - Street 2:STE 100
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-3529
Mailing Address - Country:US
Mailing Address - Phone:215-822-0900
Mailing Address - Fax:215-822-0921
Practice Address - Street 1:165 VETERANS CIR
Practice Address - Street 2:STE 100
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-3529
Practice Address - Country:US
Practice Address - Phone:215-822-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4818603336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3991038OtherNCPDP PROVIDER IDENTIFICATION NUMBER